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A short view of dying

14 March 2014

NORMAN LAMB is Minister of State for Care and Support in the Department of Health. Included among his responsibilities are older people, carers, and end-of-life care. It is extraordinary that someone in such a position should favour assisted dying - and that someone with such views should continue to hold such a position. His approach, that "the state should not stand in the way" of an individual's wishes, sounds like the Liberal Democrat ethos, except that it neglects the Party's commitment to social justice for the vulnerable. He said at the weekend that his view had been formed by talking to terminally ill people. There are undoubtedly hard cases, and anyone involved in caring for those who are seriously ill cannot be dismissive of their concerns.

But the care of the articulate patient cannot be viewed in isolation from that of patients who are not yet in a position to be affected by any change in the legisation as it relates to assisting suicide. In the Nicklinson/Paul Lamb appeal last year, Lord Judge, now a former Lord Chief Justice, said in his ruling: "For these purposes, Parliament represents the conscience of the nation." The danger with this notion is that Parliament is made up largely of politicians, the lower House exclusively so. They know that voters are swayed by the real and poignant examples that are laid before them of people who wish to end their lives at a time of their own choosing. These naturally carry more weight than stories that hang in the future, as yet imagined stories of vulnerable people nudged towards a premature death, or the further dismantling of palliative-care services for people who stubbornly refuse to take the cost-effective way out - but we would expect a politician of Mr Lamb's seniority to see the consequences of his preferred option. If he cannot, his department is in touch with a body of people who might advise him: 77 per cent of GPs oppose any legalisation of assisted dying.

Mr Lamb is concerned about friends and family members who fear they might be prosecuted for helping someone end his or her life. But the guidance given four years ago by Keir Starmer, then the Director of Public Prosecutions, struck a balance between lifting the ban and a relentless pursuit of grieving relatives. Compassion has been exercised in about 90 cases that have been investigated since the guidance was issued, but it is good that the shadow of the law hangs over such a serious act. This was the convincing view of Parliament ("the conscience of the nation") as recently as March 2012. The motion that came out of that debate welcomed the DPP's guidance and encouraged the "further development of specialist palliative care and hospice provision". Palliative care needs first to be understood: doctors are content to administer pain-relieving drugs such as morphine, knowing that one of the drug's side-effects may prove fatal. Second, such care needs to be available universally, so that the fear of dying can be eased by confidence in the care system - a system that stretches up to the Minister for Care.

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